Blog topic
Specialty billing
Every specialty bills differently: therapy is paid by the minute, behavioral health by the length of the session, DME by the item and its paperwork. These guides cover the codes, modifiers and payer rules that matter in each specialty, with worked examples, and link to the specialty’s own page.
Specialty billing
90837 vs 90834: Billing Therapy Time Without Audits
CPT 90834 is 38 to 52 minutes of psychotherapy; 90837 is 53 minutes or more. The minutes documented in the note decide the code, not the length of the appointment slot. Here are the time bands, worked session examples, the add-on codes, and the documentation that holds up in a review.
Specialty billing
CPT 90791 vs 90792: Differences, Billing Rules and Mistakes
CPT 90791 is a psychiatric diagnostic evaluation without medical services; 90792 is the same evaluation with medical services. Which one you bill depends on what the note shows was done. Here is how to choose, what Medicare won't let you bill with them, and the mistakes that cause denials.
Specialty billing
Physical Therapy Billing Mistakes: How to Spot and Fix Them
Seven billing and coding mistakes that cost physical therapy practices money: unit counting under the 8-minute rule, the GP and KX modifiers, code pairs that need 59 or an X modifier, untimed codes, plans of care, progress reports and 97014. How to spot each in your own claims, and how to fix it.
Specialty billing
How to Get Paid Faster for DME: Why Claims Stall
Many DME claims stall on the paperwork, not the payer: an incomplete order, missing proof of delivery, a face-to-face visit or prior authorization Medicare needed before delivery, or the wrong rental modifier. What Medicare requires for each, and what a supplier can check before billing.
Specialty billing
Behavioral Health Billing Denials: Causes and Fixes
Most behavioral health denials come from a few causes: a time code the note doesn't support, an add-on billed without its E/M visit, a claim sent to the wrong company, telehealth details and thin notes. Here is each one, the reason code it comes back with, and what to change.
Specialty billing
What Is Internal Medicine Billing? A Guide for Internists
Internal medicine billing turns an internist's visits into coded claims and follows them until they're paid. It is harder than most because one visit often covers several chronic conditions, a preventive service and a Medicare patient. Here is how it works, where it goes wrong and what to check.
Specialty billing
Medicare 8-Minute Rule: How to Bill Timed Therapy Units
Under the Medicare 8-minute rule, you add up all the timed therapy minutes in a day and bill one 15-minute unit for every 15 minutes, with 8 or more minutes left over counting as one more unit. Here is the unit chart, CMS's own worked examples and the mistakes that get therapy claims cut.
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